USMLE Forum Archives - USMLE Step 2 CK - GYNAEC: PAP SMEAR
GYNAEC: PAP SMEAR
bingousmle - 05-10-09 13:38
A 27-year-old woman presents to your office for a routine annual visit. Her medical history is unremarkable. She is nulliparous and has been sexually active since the age of 17. She has been regularly having Pap smears since she was 21 and the result each time was negative. She does not have any particular complaints and pelvic examination reveals nothing abnormal. You perform a Pap smear, which reveals the presence of dysplasia. Which of the following is the most appropriate next step in management?
bingousmle - 05-10-09 13:38
A 27-year-old woman presents to your office for a routine annual visit. Her medical history is unremarkable. She is nulliparous and has been sexually active since the age of 17. She has been regularly having Pap smears since she was 21 and the result each time was negative. She does not have any particular complaints and pelvic examination reveals nothing abnormal. You perform a Pap smear, which reveals the presence of dysplasia. Which of the following is the most appropriate next step in management?
The correct answer and explanation will be available after you answer.
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#1
Re: GYNAEC: PAP SMEAR usmlefever3 - 05-10-09 13:53 My answer is: d.
in premenopausal women colposcopy is done for CIN 1
#46
Re: GYNAEC: PAP SMEAR komalz - 02-01-10 19:26 My answer is: e.
in dysplasia no need to do any thing especially when previous smears are normal.at least 6 month gap is needed to repeat
#60
Re: GYNAEC: PAP SMEAR ammulufy - 03-18-10 07:47 My answer is: c.
Shiller's test is not indicated here at all.We cannot wait till 6 weeks also bcos dat can lead to further progression of the cancer.Colposcopy is done only after carcinomatous status is confirmed to know whether metastasis has occured or not.Hence the answer is immediate conization n sent d tissue for biopsy.
#61
Re: GYNAEC: PAP SMEAR ammulufy - 03-18-10 07:49 Just dysplasia does not suggest dat metastasis has occured.....dysplasia is the precursor of carcinomatous changes n does not indicate metastasis....can u please explain me y colposcopy is the answer.....I know the person is to be staged for the cancer....dat is to be done only when the cervical cancer is confirmed after conization......
#66
Re: GYNAEC: PAP SMEAR therockbigfight - 04-30-10 16:05 While Dysplasia is not cancer, it can develop into cancer of the cervix. Mild cervical dysplasia (CIN I) sometimes goes away without treatment, but most doctors will still treat it at this very early stage to prevent it from progressing to a more advanced form of dysplasia. We simply do not know nor do we have a way of predicting yet which CIN I cells will become normal again and which ones will progress to CIN II and eventually Cervical Cancer.
#74
Re: GYNAEC: PAP SMEAR babbu5508 - 05-21-10 02:49 My answer is: d.
any abnormal findings in the pap smear like those of dysplasia should be confirmed by colposcopic directed biopsies...preferably with hpv testing...
#77
Re: GYNAEC: PAP SMEAR mtniharika - 05-25-10 04:14 
posted by ammulufy on 03-18-10 07:49
Just dysplasia does not suggest dat metastasis has occured.....dysplasia is the precursor of carcinomatous changes n does not indicate metastasis....can u please explain me y colposcopy is the answer.....I know the person is to be staged for the cancer....dat is to be done only when the cervical cancer is confirmed after conization......
Just dysplasia does not suggest dat metastasis has occured.....dysplasia is the precursor of carcinomatous changes n does not indicate metastasis....can u please explain me y colposcopy is the answer.....I know the person is to be staged for the cancer....dat is to be done only when the cervical cancer is confirmed after conization......
all abnormal smears are to be confirmed by colposcopic guided biopsies according to the guidelines..though it is not a cancer yet,it has potential to develop into
#79
Re: GYNAEC: PAP SMEAR babbu5508 - 05-25-10 17:06 posted by mtniharika on 05-25-10 04:14
all abnormal smears are to be confirmed by colposcopic guided biopsies according to the guidelines..though it is not a cancer yet,it has potential to develop into
all abnormal smears are to be confirmed by colposcopic guided biopsies according to the guidelines..though it is not a cancer yet,it has potential to develop into
exactly...
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